Not in the vein: 'missed hits', subcutaneous and intramuscular injections and associated harms among people who inject psychoactive drugs in Bristol, United Kingdom
Not in the vein: 'missed hits', subcutaneous and intramuscular injections and associated harms among people who inject psychoactive drugs in Bristol, United Kingdom
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DOI：
10.1016/j.drugpo.2015.11.003
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发表时间：
2016-02-01
影响因子：
4.4
通讯作者：
Hickman, M.
中科院分区：
文献类型：
--
作者：
Hope, V. D.;Parry, J. V.;Hickman, M.
背景资料：在注射毒品的人群中，很少研究有意或意外皮下和肌内注射的程度以及与这些相关的因素，但这些因素可能在获得性细菌感染中发挥重要作用。本研究描述了这些的程度，特别是与意外皮下和肌内注射（即“错过的命中”）的因素和危害：人谁注射毒品被招募使用响应驱动的抽样。加权数据进行了检查，使用双变量分析和logistic regression.Results：参与者的平均年龄为33岁（31%年龄在30岁以下），28%是女性，平均时间为12年（N = 329），因为第一次注射。在过去的三个月里，97%的人注射过海洛因，71%的人注射过快克可卡因，16%的人注射过安非他明; 36%的人每天注射。总体而言，99%（325例）报告其旨在静脉注射;仅3例旨在皮下注射，1例旨在肌内注射。在那些旨在静脉注射的患者中，56%（181例）报告曾丢失静脉（51例患者平均每月发生4次以上）。与“漏诊”相关的因素表明，这些是不良血管通路、注射技术和/或卫生的结果。“错过的命中”是常见的两倍，在那些报告疮/开放性伤口，肿胀，或发红，肿胀和压痛injection situation.Conclusion：故意皮下和肌内注射是罕见的，在这个样本。“未命中”很常见，似乎与不良的注射实践有关。需要采取干预措施，通过改善注射做法和卫生来降低风险。皇冠版权所有（C）2015由Elsevier B. V.出版。保留所有权利。
Background: The extent of intentional or accidental subcutaneous and intramuscular injections and the factors associated with these have rarely been studied among people who inject drugs, yet these may play an important role in the acquisition bacterial infections. This study describes the extent of these, and in particular the factors and harms associated with accidental subcutaneous and intramuscular injections (i.e. 'missed hits').Methods: People who inject drugs were recruited using respondent driven sampling. Weighted data was examined using bivariate analyses and logistic regression.Results: The participants mean age was 33 years (31% aged under 30-years), 28% were women, and the mean time since first injection was 12 years (N = 329). During the preceding three months, 97% had injected heroin, 71% crack-cocaine, and 16% amphetamines; 36% injected daily. Overall, 99% (325) reported that they aimed to inject intravenously; only three aimed to inject subcutaneously and one intramuscularly. Of those that aimed to inject intravenously, 56% (181) reported ever missing a vein (for 51 this occurred more than four times month on average). Factors associated with 'missed hits' suggested that these were the consequence of poor vascular access, injection technique and/or hygiene. 'Missed hits' were twice as common among those reporting sores/open wounds, abscesses, or redness, swelling and tenderness at injection sites.Conclusion: Intentional subcutaneous and intramuscular injections are rare in this sample. 'Missed hits' are common and appear to be associated with poor injection practice. Interventions are required to reduce risk through improving injecting practice and hygiene. Crown Copyright (C) 2015 Published by Elsevier B.V. All rights reserved.